Provider First Line Business Practice Location Address:
1 HOSPITAL PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26301-9215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-624-2224
Provider Business Practice Location Address Fax Number:
304-624-2787
Provider Enumeration Date:
09/27/2006